Abstract

Nimotuzumab is a humanized monoclonal antibody against the Epidermal Growth Factor Receptor with a long history of therapeutic use, recognizing an epitope different from the ones targeted by other antibodies against the same antigen. It is also distinguished by much less toxicity resulting in a better safety profile, which has been attributed to its lower affinity compared to these other antibodies. Nevertheless, the ideal affinity window for optimizing the balance between anti-tumor activity and toxic effects has not been determined. In the current work, the paratope of the phage-displayed nimotuzumab Fab fragment was evolved in vitro to obtain affinity-matured variants. Soft-randomization of heavy chain variable region CDRs and phage selection resulted in mutated variants with improved binding ability. Two recombinant antibodies were constructed using these variable regions, which kept the original fine epitope specificity and showed moderate affinity increases against the target (3-4-fold). Such differences were translated into a greatly enhanced inhibitory capacity upon ligand-induced receptor phosphorylation on tumor cells. The new antibodies, named K4 and K5, are valuable tools to explore the role of affinity in nimotuzumab biological properties, and could be used for applications requiring a fine-tuning of the balance between binding to tumor cells and healthy tissues.

Highlights

  • Nimotuzumab is a humanized monoclonal antibody against the Epidermal Growth Factor Receptor with a long history of therapeutic use, recognizing an epitope different from the ones targeted by other antibodies against the same antigen

  • A recent meta-analysis of 65 randomized controlled trials indicated that the use of anti-epidermal growth factor receptor (EGF-R) monoclonal antibodies (mAbs) significantly increases the risk of developing skin toxicity, but patients receiving nimotuzumab have the lowest risk among all[6]

  • Nimotuzumab-derived Fab variants having an increased EGF-R binding ability were selected from a phage-displayed library

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Summary

Introduction

Nimotuzumab is a humanized monoclonal antibody against the Epidermal Growth Factor Receptor with a long history of therapeutic use, recognizing an epitope different from the ones targeted by other antibodies against the same antigen. Nimotuzumab is the only anti-EGF-R mAb that can be chronically used[3], in contrast to cetuximab and panitumumab, for which skin toxicity often determines the need of dose reduction or therapy discontinuation Such a favorable safety profile has been attributed to its lower affinity (KD in the order of 10−8 mol/L), that results in maximum uptake by EGF-R-overexpressing tumors and negligible binding to normal epithelial cells displaying basal EGF-R levels[8]. A careful review of clinical studies shows that nimotuzumab benefit seems to be biased towards the subset of patients with higher EGF-R levels[3] Such a selectivity can be attributed to the lower affinity of nimotuzumab compared to other anti-EGF-R mAbs. The ideal affinity window resulting in an optimal ratio between effective tumor targeting and minimal effects on normal epithelial cells is not known, and could be explored through in vitro evolution of variants of the same antibody with different affinities

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